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(11) | EP 2 436 341 A1 |
| (12) | EUROPEAN PATENT APPLICATION |
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| (54) | Femoral component of a knee prosthesis |
| (57) An implantable orthopaedic knee prosthesis includes a femoral component that is configured
to be coupled to a surgically-prepared distal femur. The femoral component has an
articular side that includes a posterior femoral condyle surface. A fixation side
is opposite the articular side, and it includes a posterior fixation surface that
extends generally in the superior/inferior direction. The posterior fixation surface
has an angled posterior cement pocket formed therein.
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[0002] During the lifetime of a patient, it may be necessary to perform a joint replacement procedure on the patient as a result of, for example, disease or trauma. The joint replacement procedure may involve the use of a prosthesis which is implanted into one or more of the patient's bones. In the case of a knee replacement procedure, a tibial tray is implanted into the patient's tibia. A bearing is secured to the tibial tray. The condyle surfaces of a replacement femoral component bear against the tibial bearing.
[0003] During implantation of the femoral component, the surgeon typically preloads bone cement on the bone-contacting surfaces of the component. The preloaded bone cement has a tendency to escape the femoral component as it is positioned on the surgically-prepared distal femur. Advancement of the femoral component through escaped bone cement is referred to as "cement ploughing". Both the escaped bone cement and the associated cement plowing lead to the performance of additional surgical steps to remove the extraneous bone cement prior to completion of the surgical procedure.
[0004] In one aspect, the invention provides an implantable orthopaedic knee prosthesis which includes a femoral component that is configured to be coupled to a surgically-prepared distal femur. The femoral component has an articular side that includes a posterior femoral condyle surface. A fixation side is opposite the articular side, and it includes a posterior fixation surface that extends generally in the superior/inferior direction. The posterior fixation surface has a posterior cement pocket formed therein that is deeper at its inferior end than at its superior end.
[0005] Optionally, the fixation side of the femoral component may also include a distal fixation surface that extends generally in the anterior/posterior direction and a posterior-chamfer fixation surface that extends superiorly and posteriorly from the distal fixation surface in the direction toward the posterior fixation surface. Optionally, the posterior-chamfer surface may have a posterior-chamfer cement pocket formed therein that is contiguous with the posterior cement pocket. Similarly, the distal fixation surface may have a distal cement pocket formed therein that is contiguous with the posterior-chamfer cement pocket.
[0006] Optionally, the posterior cement pocket may be deeper at its inferior end than both the posterior-chamfer cement pocket and the distal cement pocket.
[0007] Optionally, the fixation side of the femoral component may also include an anterior fixation surface that extends generally in the superior/inferior direction, and an anterior-chamfer fixation surface that extends superiorly and anteriorly from the distal fixation surface in the direction toward the anterior fixation surface. The anterior-chamfer surface may have an anterior-chamfer cement pocket formed therein that is contiguous with the distal cement pocket. The anterior fixation surface may include an anterior cement pocket formed therein that is contiguous with the anterior-chamfer cement pocket.
[0008] Optionally, the posterior cement pocket is deeper at its inferior end than both the anterior-chamfer cement pocket and the anterior cement pocket.
[0009] Optionally, the posterior fixation surface includes a mounting rim having a sidewall extending posteriorly therefrom. The sidewall defines the perimeter of the posterior cement pocket. When viewed sagittally, an inferior end of the sidewall is wider than a superior end of the sidewall.
[0010] In another aspect, the invention provides an implantable orthopaedic knee prosthesis which includes a femoral component configured to be coupled to a surgically-prepared distal femur. The femoral component may include an articular side having a posterior femoral condyle surface, and a fixation side that is opposite the articular side. The fixation side may include a posterior fixation surface that extends generally in the superior/inferior direction. The posterior fixation surface may include a peripheral rim, a bottom wall spaced apart posteriorly from the peripheral rim, and a sidewall extending posteriorly from the posterior rim to the bottom wall. When viewed sagittally, an imaginary plane defined by the peripheral rim forms an acute angle with an imaginary plane defined by the bottom wall.
[0011] When viewed sagittally, an inferior end of the sidewall may be wider than a superior end of the sidewall.
[0013] The articular side may include a posterior lateral femoral condyle surface. The articular side may include a posterior medial femoral condyle surface.
[0014] According to another aspect, an implantable orthopaedic knee prosthesis includes a tibial tray configured to be coupled to a surgically-prepared proximal tibia and a bearing coupled to the tibial tray. The bearing includes a medial articular surface and a lateral articular surface. The knee prosthesis may also include a femoral component configured to be coupled to a surgically-prepared distal femur. The femoral component may include a lateral condyle surface configured to articulate with the lateral articular surface of the bearing and a medial condyle configured to articulate with the medial articular surface of the bearing. The femoral component may also include a posterior lateral fixation surface opposite the lateral condyle surface, with the posterior lateral fixation surface extending in the superior/inferior direction. The femoral component also includes a posterior medial fixation surface opposite the medial condyle surface, with the posterior medial fixation surface extending in the superior/inferior direction. Both the posterior medial fixation surface and the posterior lateral fixation surface may include a peripheral rim, a bottom wall spaced apart posteriorly from the peripheral rim, and a sidewall extending posteriorly from the posterior rim to the bottom wall. When viewed sagittally, an imaginary plane defined by the peripheral rim forms an acute angle with an imaginary plane defined by the bottom wall.
[0015] Optionally, when viewed sagittally, an inferior end of the sidewall of the posterior medial fixation surface may be wider than its superior end.
[0016] Optionally, when viewed sagittally, an inferior end of the sidewall of the posterior lateral fixation surface may be wider than its superior end.
[0017] Optionally, the sidewall and the bottom wall of the posterior medial fixation surface collectively may define a cement pocket.
[0018] The sidewall and the bottom wall of the posterior lateral fixation surface may collectively define a cement pocket.
[0019] According to another aspect, an implantable orthopaedic knee prosthesis includes a femoral component configured to be coupled to a surgically-prepared distal femur. The femoral component has an articular side that includes a femoral condyle surface and a fixation side that is opposite the articular side. The fixation side includes a fixation surface that extends generally in the superior/inferior direction. The fixation surface has a cement pocket formed therein that is deeper at its inferior end than at its superior end.
[0020] Optionally, the fixation surface may include a mounting rim that has a sidewall extending therefrom. The sidewall defines the perimeter of the cement pocket. When viewed sagittally, the inferior end of the sidewall is wider than the superior end of the sidewall.
[0021] Optionally, when viewed sagittally, an imaginary plane defined by the peripheral rim may form an acute angle with an imaginary plane defined by the bottom wall.
[0022] Optionally, the fixation surface may include a posterior fixation surface having a posterior cement pocket formed therein. In such an arrangement, the bottom wall is spaced apart posteriorly from the peripheral rim, and the sidewall extends posteriorly from the posterior rim to the bottom wall.
[0023] Optionally, the fixation surface may include an anterior fixation surface having an anterior cement pocket formed therein. In such an arrangement, the bottom wall is spaced apart anteriorly from the peripheral rim, and the sidewall extends anteriorly from the anterior rim to the bottom wall.
[0025] Embodiments of the invention are described below by way of example with reference to the accompanying drawings, in which:
FIG. 1 is a perspective view of a knee prosthesis;
FIG. 2 is an exploded perspective view of the knee prosthesis of FIG. 1;
FIG. 3 is a perspective view of the femoral component of the knee prosthesis of FIG. 1;
FIG. 4 is a sagittal cross section view of the femoral component of FIG. 3;
FIG. 5 is an enlarged, fragmentary view of a portion of FIG. 4 showing the posterior condyles of the femoral component in greater detail;
FIG. 6 is a view similar to FIG. 4, but showing another embodiment of the femoral component in which both the posterior and anterior cement pockets are angled;
FIG. 7 is a perspective view of a unicompartmental femoral component; and
FIG. 8 is a sagittal cross sectional view of the unicompartmental femoral component of FIG. 7.
[0026] Terms representing anatomical references, such as anterior, posterior, medial, lateral, superior, inferior, etc may be used throughout this disclosure in reference to both the orthopaedic implants described herein and a patient's natural anatomy. Such terms have well-understood meanings in both the study of anatomy and the field of orthopaedics. Use of such anatomical reference terms in the specification and claims is intended to be consistent with their well-understood meanings unless noted otherwise.
[0027] Referring to the drawings, FIGS. 1 to 5 is show a knee prosthesis 10 which includes a femoral component 12, a tibial tray 14, and a bearing 16. The femoral component 12 is configured to be secured to a surgically-prepared end of a patient's distal femur (not shown), whereas the tibial tray 14 is configured to be secured to a surgically-prepared end of a patient's proximal tibia (not shown).
[0028] The tibial tray 14 includes a platform 18 having a fixation member, such as an elongated stem 20, extending away from its lower surface. The bearing 16 includes a stem 22 (see FIG. 2) which can be positioned within a complementary bore 24 (see FIG. 2) in the tibial tray 14. In such a way, the bearing 16 is free to rotate relative to the tibial tray 14. In other embodiments, the bearing 16 may be snap-fit or otherwise secured to the tibial tray 14. In such a way, the bearing 16 is fixed relative to the tibial tray 14 (i.e., it does not rotate or move in the anterior/posterior or medial/lateral directions). It should be appreciated that in such embodiments, other fixation members, such as one or more short pegs or posts, may be used in lieu of the elongated stem 20.
[0029] The bearing 16 includes a lateral articular surface 26 and a medial articular surface 28. The articular surfaces 26, 28 are configured to articulate with a lateral condyle surface 30 and a medial condyle surface 32, respectively, of the femoral component 12. Specifically, the femoral component 12 is configured to emulate the configuration of the patient's natural femoral condyles, and, as such, the lateral condyle surface 30 and the medial condyle surface 32 are configured (e.g., curved) in a manner which mimics the condyles of the natural femur. The lateral condyle surface 30 and the medial condyle surface 32 are spaced apart from one another thereby defining an intercondylar notch between them.
[0030] The components of the knee prosthesis 10 that engage the natural bone, such as the femoral component 12 and the tibial tray 14, may be constructed with a biocompatible metal, such as a cobalt chrome alloy, although other materials, such as ceramics, may also be used. The bone engaging surfaces of these components may be textured to facilitate cementing the component to the bone. Such surfaces may have porous regions to promote bone ingrowth for permanent fixation, for example by means of a coating of a porous material.
[0031] The bearing 16 may be constructed with a material that allows for smooth articulation between the bearing 16 and the femoral component 12, such as a polymeric material. One such polymeric material is polyethylene such as ultrahigh molecular weight polyethylene (UHMWPE), although other biocompatible polymers may be used.
[0032] Although the femoral component 12 which is shown in the drawings is a monolithic component, it is characterized by a number of "regions" or "structures". For example, the anterior structure of the femoral component 12 is referred to as an anterior flange 34. The anterior flange 34 transitions to an anterior chamfer region 36, which, in turn, transitions to a distal condylar region 38. The distal condylar region 38 transitions to a posterior chamfer region 40. A pair of posterior femoral condyles 42 form the posterior structure of the femoral component 12.
[0033] As shown in FIG. 2, both the lateral condyle surface 30 and the medial condyle surface 32 are formed in the articular side 44 of the femoral component 12. A fixation side 48 is opposite the articular side 44, and is the side of the femoral component 12 that contacts the surgically-prepared distal femur of the patient. The fixation side 48 includes multiple surfaces that mate with planar surfaces surgically cut into the patient's distal femur. Specifically, as shown in FIG. 3, a pair of posterior fixation surfaces 50 are opposite the posterior condyle surfaces 52, with one of the posterior fixation surfaces 50 being the medial fixation surface, the other the lateral fixation surface. As can be seen in FIG. 4, the posterior fixation surfaces 50 extend generally in the superior/inferior direction. A pair of distal fixation surfaces 58 (one being medially positioned, the other the laterally positioned) are opposite the distal condyle surfaces 60. The distal fixation surfaces 58 extend generally in the anterior/posterior direction. The medial and lateral posterior-chamfer fixation surfaces 54 are opposite the posterior-chamfer condyle surfaces 56. The medial and lateral posterior-chamfer fixation surfaces 54 extend superiorly and posteriorly from their respective medial and lateral distal fixation surfaces 58 in the direction toward their respective posterior fixation surfaces 50. The medial and lateral anterior-chamfer fixation surfaces 62 are opposite the anterior-chamfer condyle surfaces 64, respectively, and extend superiorly and anteriorly away from their respective distal fixation surfaces 58 in the direction toward an anterior fixation surface 66. The anterior fixation surface 66 is opposite the anterior condyle surface 68 and, like the posterior fixation surfaces 50, extends generally in the superior/inferior direction.
[0034] Each of the fixation surfaces has a cement pocket formed therein. In particular, a posterior cement pocket 70 is formed in each of the posterior fixation surfaces 50, a posterior-chamfer cement pocket 72 is formed in each of the posterior-chamfer fixation surfaces 54, a distal cement pocket 74 is formed in each of the distal fixation surfaces 58, an anterior-chamfer cement pocket 76 is formed in each of the anterior-chamfer fixation surfaces 62, and an anterior cement pocket 78 is formed in the anterior fixation surface 66. In the illustrative embodiment described herein, the adjacent cement pockets are contiguous with one another such that a single, continuous cement pocket is formed in the fixation side 48 of the femoral component.
[0035] Each of the cement pockets 70, 72, 74, 76, 78 is formed by a sidewall 80 that extends away from a mounting rim 82. As can be seen in FIGS. 3 to 5, the sidewall 80 forms the perimeter of the respective cement pockets 70, 72, 74, 76, 78. A bottom wall 84 is spaced apart from the mounting rim 82 and is connected thereto by the sidewall 80. In such a way, the sidewall 80 and the bottom wall 84 collectively define the respective cement pockets 70, 72, 74, 76, 78.
[0036] The depth (D1) of each of the posterior-chamfer cement pocket 72, the distal cement pocket 74, the anterior-chamfer cement pocket 76, and the anterior cement pocket 78 is approximately equal. In the illustrative embodiment described herein, each of the cement pockets 72, 74, 76, and 78 is approximately 1 mm deep (i.e., D1 = 1 mm).
[0037] The posterior cement pocket 70, on the other hand, is angled and, as a result, is deeper at its inferior end than on its superior end. In particular, as shown in FIG. 5, the posterior cement pocket 70 is formed by a sidewall 80' that extends posteriorly from the mounting rim 82' of the posterior fixation surface 50 to the bottom wall 84'. When viewed sagittally, such as in the cross sectional view of FIGS. 4 and 5, the inferior end 86 of the sidewall 80' is wider than the superior end 88 of the sidewall 80'. As a result, the posterior cement pocket 70 is deeper at its inferior end 90 than at its superior end 92. In the illustrative embodiment described herein, the superior end 92 of the posterior cement pocket 70 is approximately equal to the depth of the other cement pockets 72, 74, 76, and 78. In other words, the superior end 92 of the posterior cement pocket 70 is approximately 1 mm deep (i.e., D 1 = 1 mm). However, the inferior end 90 of the posterior cement pocket 70 is illustratively 1.5 mm deep (i.e., D2 = 1.5 mm). It should be appreciated that other dimensions may also be used to fit the need of a given design of the femoral component 12.
[0038] Such an arrangement creates an angled bottom wall 84'. In particular, the bottom wall 84' slopes anteriorly from its inferior end 86 to its superior end 88. This sloped arrangement is shown in the cross sectional view of FIG. 5. As can be seen in that view, an imaginary plane 94 is defined by the mounting rim 82' of the posterior fixation surface 50, whereas the bottom wall 84' of the posterior fixation surface 50 defines an imaginary plane 96. The two imaginary planes 94, 96 form an acute angle (θ) between them. Such an acute angle is indicative of the slope of the bottom wall 84' relative to the mounting rim 82'.
[0039] During a surgical procedure to implant the femoral component 12 in the surgically-prepared distal end of the patient's femur, the cement pockets 70, 72, 74, 76, 78 are preloaded with bone cement. The femoral component 12 is then positioned on the patient's surgically-prepared distal femur, which has also been coated in bone cement. The angled arrangement of posterior cement pocket 70 hydraulically loads the bone cement within the cement pocket. This enhances containment of the bone cement and reduces the occurrences of cement plowing. The arrangement of the posterior cement pocket 70 also improves filling of the bone cement and pressurization which, in turn, leads to enhanced bonding of the femoral component 12 to the distal femur.
[0040] FIG. 6 shows another embodiment of the femoral component 12 in which both the posterior cement pocket 70 and the anterior cement pocket 78 are angled. As such, both cement pockets 70, 78 are deeper at their respective inferior ends than at their respective superior ends. In the embodiment shown in FIG. 6, the posterior cement pocket 70 is essentially the same as discussed above with reference to FIGS. 1 to 5. As to the anterior cement pocket 78, it is formed by a sidewall 80" that extends anteriorly from the mounting rim 82" of the anterior fixation surface 66 to the bottom wall 84". When viewed sagittally, such as in the cross sectional view of FIG. 6, the inferior end 106 of the sidewall 80" is wider than the superior end 108 of the sidewall 80". As a result, like the posterior cement pocket 70, the anterior cement pocket 78 is deeper at its inferior end 110 than at its superior end 112. In this embodiment, the superior end 112 of the anterior cement pocket 78 is approximately equal to the depth of the other cement pockets 72, 74, and 76. In other words, the superior end 112 of the anterior cement pocket 70 is approximately 1 mm deep (i.e., D1 = 1 mm). However, the inferior end 110 of the anterior cement pocket 78 is illustratively 1.5 mm deep (i.e., D2 = 1.5 mm). It should be appreciated that other dimensions may also be used to fit the need of a given design of the femoral component 12.
[0041] Such an arrangement creates an angled bottom wall 84". In particular, the bottom wall 84" of the anterior cement pocket 78 slopes posteriorly from its inferior end 106 to its superior end 108. This sloped arrangement is shown in FIG. 6 in which an imaginary plane 114 is defined by the mounting rim 82" of the anterior fixation surface 66, whereas the bottom wall 84" of the anterior fixation surface 66 defines an imaginary plane 116. The two imaginary planes 114, 116 form an acute angle (β) between them. Such an acute angle is indicative of the slope of the bottom wall 84" relative to the mounting rim 82".
[0042] During a surgical procedure to implant the femoral component 12 of FIG. 6 in the surgically-prepared distal end of the patient's femur, the cement pockets 70, 72, 74, 76, 78 are preloaded with bone cement. The femoral component 12 is then positioned on the patient's surgically-prepared distal femur, which has also been coated in bone cement. The angled arrangement of the cement pockets 70, 78 hydraulically loads the bone cement within the cement pockets 70, 78. This enhances containment of the bone cement and reduces the occurrences of cement plowing. This also improves filling of the bone cement and pressurization which, in turn, leads to enhanced bonding of the femoral component 12 to the distal femur.
[0043] It should be appreciated that although the embodiment of FIG. 6 shows both the posterior cement pocket 70 and the anterior cement pocket 78 being angled, it should be appreciated that other embodiments are also contemplated. For example, as shown in FIGS. 1 to 5, the femoral component 12 may be embodied with only the posterior cement pocket 70 being angled. Alternatively, the femoral component 12 may be embodied with only the anterior cement pocket 78 being angled.
[0044] Referring now to FIGS. 7 and 8, the femoral component 12 may also be embodied as a unicompartmental femoral component. As in other embodiments, the posterior cement pocket 70 of the unicompartmental femoral component 12 may be angled. The angled arrangement of posterior cement pocket 70 hydraulically loads the bone cement within the cement pocket. This enhances containment of the bone cement and reduces the occurrences of cement plowing. The arrangement of the posterior cement pocket 70 also improves filling of the bone cement and pressurization which, in turn, leads to enhanced bonding of the unicompartmental femoral component 12 to the distal femur.
1. A femoral component of an implantable orthopaedic knee prosthesis which is configured
to be coupled to a surgically-prepared distal femur, the femoral component having
(i) an articular side comprising a posterior femoral condyle surface, and (ii) a fixation
side that is opposite the articular side, the fixation side comprising a posterior
fixation surface that extends generally in the superior/inferior direction, in which
the posterior fixation surface has a posterior cement pocket formed therein, the posterior
cement pocket is deeper at its inferior end than at its superior end.
2. The femoral component of claim 1, in which:
the fixation side of the femoral component further comprises (i) a distal fixation surface that extends generally in the anterior/posterior direction, and (ii) a posterior-chamfer fixation surface that extends superiorly and posteriorly from the distal fixation surface in the direction toward the posterior fixation surface,
the posterior-chamfer surface has a posterior-chamfer cement pocket formed therein that is contiguous with the posterior cement pocket, and
the distal fixation surface has a distal cement pocket formed therein that is contiguous with the posterior-chamfer cement pocket.
3. The femoral component of claim 2, in which the depth of posterior cement pocket at
its inferior end is greater than that of each of the posterior-chamfer cement pocket
and the distal cement pocket.
4. The femoral component of claim 3, in which:
the fixation side has (i) an anterior fixation surface that extends generally in the superior/inferior direction, and (ii) an anterior-chamfer fixation surface that extends superiorly and anteriorly from the distal fixation surface in the direction toward the anterior fixation surface,
the anterior-chamfer surface has an anterior-chamfer cement pocket formed therein that is contiguous with the distal cement pocket, and
the anterior fixation surface has an anterior cement pocket formed therein that is contiguous with the anterior-chamfer cement pocket.
5. The femoral component of claim 4, in which the depth of the posterior cement pocket
at its inferior end is greater than that of each of the anterior-chamfer cement pocket
and the anterior cement pocket.
6. The femoral component of claim 1, in which:
the posterior fixation surface comprises a mounting rim having a sidewall extending posteriorly therefrom,
the sidewall defines the perimeter of the posterior cement pocket, and
when viewed sagittally, the width of the sidewall is greater at its inferior end than at its superior end.
7. The femoral component of claim 1, in which:
(a) the posterior fixation surface comprises (i) a peripheral rim, (ii) a bottom wall spaced apart posteriorly from the peripheral rim, and (iii) a sidewall extending posteriorly from the posterior rim to the bottom wall, and
(b) when viewed sagittally, an imaginary plane defined by the peripheral rim forms an acute angle with an imaginary plane defined by the bottom wall.
8. The femoral component of claim 7, in which, when viewed sagittally, the width of the
sidewall is greater at its inferior end than at its superior end.
9. An implantable orthopaedic knee prosthesis, comprising:
a tibial tray configured to be coupled to a surgically-prepared proximal tibia,
a bearing coupled to the tibial tray, the bearing having a medial articular surface and a lateral articular surface, and
a femoral component as claimed in claim 1, which has (i) a lateral condyle surface configured to articulate with the lateral articular surface of the bearing and a medial condyle configured to articulate with the medial articular surface of the bearing, (ii) a posterior lateral fixation surface opposite the lateral condyle surface, the posterior lateral fixation surface extending in the superior/inferior direction, and (iii) a posterior medial fixation surface opposite the medial condyle surface, the posterior medial fixation surface extending in the superior/inferior direction,
in which both the posterior medial fixation surface and the posterior lateral fixation surface comprise (i) a peripheral rim, (ii) a bottom wall spaced apart posteriorly from the peripheral rim, and (iii) a sidewall extending posteriorly from the posterior rim to the bottom wall,
in which, when viewed sagittally, an imaginary plane defined by the peripheral rim forms an acute angle with an imaginary plane defined by the bottom wall.
10. The implantable orthopaedic knee prosthesis of claim 9, in which, when viewed sagittally,
the width of the sidewall of at least one of the posterior medial fixation surface
and the posterior lateral fixation surface is greater at its inferior end than at
its superior end.
11. The implantable orthopaedic knee prosthesis of claim 9, in which a cement pocket is
defined by at least one of (a) the sidewall and the bottom wall of the posterior medial
fixation surface collectively define a cement pocket, and (b) the sidewall and the
bottom wall of the posterior lateral fixation surface.